Patient-perceived Barriers and Enablers to Adherence to Physiotherapist Prescribed Self-Management Strategies

The objectives of this study were to describe patient-reported adherence to physiotherapist-prescribed self-management strategies; and the perceived barriers and enablers to adherence to each strategy. Patients attending physiotherapy private practices (n = 4) were observed during their consultation. Patients prescribed one or more self-management strategies received a follow-up telephone interview within 10–14 days of the observed consultation and were asked to self-report their level of adherence and their perceived barriers and/or enablers to each prescribed strategy. Results indicated that patients (n = 108) reported receiving 177 strategies and being fully adherent to 36% (95% CI: 29-44%) of these strategies. Patient-reported adherence barriers (n = 113) and enablers (n = 172) were coded using a modified version of the World Health Organisation five dimensions of adherence. Frequently reported barriers included social/economic-related (n = 52; 46%) such as being too busy, and patient-related (n = 29; 26%) including being too tired/lack of motivation. Frequently reported enablers included therapy-related (n = 71; 41%) such as “the strategy was easy to complete”, and condition-related (n = 45; 26%) including “that the strategy helped to manage symptoms”. Thus, patient adherence may be aided by ensuring that: the strategy is less complex; it does not cause pain; it isn’t time consuming; and it leads to an improvement in condition-related symptoms.